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American Journal of Ophthalmology Nov 2013To examine if myopia is a risk factor for age-related cataract. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To examine if myopia is a risk factor for age-related cataract.
DESIGN
Systematic review and meta-analysis.
METHODS
A systematic review of the literature was performed using PubMed and Embase from their inception to March 2013 for population-based studies with data on myopia and age-related cataract, including nuclear, cortical, and posterior subcapsular (PSC) cataract. Separate meta-analyses for case-control/cross-sectional studies and cohort studies were conducted using random-effects models, with results reported as adjusted odds ratios (ORs) and relative risks (RRs), respectively.
RESULTS
A total of 38 007 subjects aged 30-97 years from 12 population-based studies were included in the meta-analysis. Meta-analysis of the 7 cross-sectional studies and 1 case-control study confirmed that myopia was associated with increasingly prevalent nuclear (pooled OR 2.81, 95% CI 1.94-4.06) and PSC cataract (pooled OR 1.93, 95% CI 1.49-2.49) but not with cortical cataract (pooled OR 1.08, 95% CI 0.90-1.30). Meta-analysis from 3 or 4 cohort studies showed nonsignificant associations of myopia with incident nuclear (pooled RR 1.25, 95% CI 0.71-2.21), cortical (pooled RR 1.21, 95% CI 0.67-2.19), and PSC cataract (pooled RR 1.26, 95% CI 0.92-1.74).
CONCLUSIONS
The associations of myopia with prevalent nuclear and PSC cataract are confirmed in meta-analysis of 8 study findings. The association of myopia with incidence of age-related cataract could not be confirmed in meta-analysis of 4 study findings.
Topics: Adult; Aged; Aged, 80 and over; Aging; Cataract; Cross-Sectional Studies; Databases, Factual; Humans; Incidence; Middle Aged; Myopia; Odds Ratio; Risk Factors
PubMed: 23938120
DOI: 10.1016/j.ajo.2013.06.005 -
BMJ Clinical Evidence Feb 2011Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990. Surgery for cataract in people with glaucoma may affect... (Review)
Review
INTRODUCTION
Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990. Surgery for cataract in people with glaucoma may affect glaucoma control.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of surgery for age-related cataract without other ocular comorbidity? What are the effects of treatment for age-related cataract in people with glaucoma? What are the effects of surgical treatments for age-related cataract in people with diabetic retinopathy? What are the effects of surgical treatments for age-related cataract in people with chronic uveitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 20 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: for people with cataract without other ocular co-morbidity: cataract surgery alone, cataract surgery with non-concomitant glaucoma surgery, concomitant cataract and glaucoma surgery, intracapsular extraction, manual (large or small) incision extracapsular extraction, and phaco extracapsular extraction; for people with cataract with co-morbid diabetic retinopathy: cataract surgery alone, and adding diabetic retinopathy treatment to cataract surgery; for people with cataract and co-morbid chronic uveitis: cataract surgery, and medical control of uveitis at the time of cataract surgery.
Topics: Cataract; Cataract Extraction; Diabetic Retinopathy; Eye; Humans; Incidence; Uveitis
PubMed: 21718561
DOI: No ID Found -
Journal of Cataract and Refractive... Nov 2023The main aim of this systematic review and meta-analysis was to evaluate the safety and efficacy profile of immediate sequential bilateral cataract surgery (ISBCS)... (Meta-Analysis)
Meta-Analysis
The main aim of this systematic review and meta-analysis was to evaluate the safety and efficacy profile of immediate sequential bilateral cataract surgery (ISBCS) compared with delayed sequential bilateral cataract surgery (DSBCS). MEDLINE Ovid, EMBASE, and CENTRAL databases were searched. Outcome measures were postoperative visual acuity, postoperative spherical equivalent (refractive outcome), endophthalmitis, corneal edema, pseudophakic macular edema, and posterior capsule rupture (PCR). 13 articles met criteria for final inclusion. A total of 11 068 622 participants (18 802 043 eyes) were included. No statistically significant differences between ISBCS and DSBCS were identified in all the postoperative outcomes evaluated. However, a higher risk for PCR was identified in the ISBCS group from the pooled analysis of nonrandomized studies (risk ratio, 1.34, 95% CI, 1.08-1.67, P = .0081). In our view, the ISBCS approach has an acceptable safety-efficacy profile, comparable with DSBCS. Future investigations are warranted, with a focus on the analysis of risk factors for surgical complications, patient-reported outcome-measures, and cost effectiveness.
Topics: Humans; Phacoemulsification; Cataract Extraction; Cataract; Visual Acuity; Ophthalmology
PubMed: 37276258
DOI: 10.1097/j.jcrs.0000000000001230 -
Eye (London, England) Sep 2023To assess the relationship between sleep duration and the risk of major eye disorders including myopia, glaucoma, cataract, age-related macular degeneration (AMD), and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To assess the relationship between sleep duration and the risk of major eye disorders including myopia, glaucoma, cataract, age-related macular degeneration (AMD), and diabetic retinopathy (DR).
METHODS
Databases including PubMed, Embase, Web of Science, and Cochrane library were searched for eligible publications before July 2021. Studies assessing the relationship between sleep duration and any one of the major eye disorders were identified. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were estimated using random-effects models.
RESULTS
We identified 21 relevant articles including 777348 participants, and 17 were cross-sectional, 3 were longitudinal, and 1 was case-control. Pooled results indicated that long sleep duration was significantly associated with the risk of DR (OR = 1.84, 95% CI 1.24, 2.73), and short sleep duration was significantly associated with the risk of cataract (OR = 1.20, 95% CI 1.05, 1.36). Besides, a significant relationship was observed between the risk of DR and long sleep duration per day (i.e., nighttime sleep plus daytime napping, OR = 1.74, 95% CI 1.23, 2.44) rather than per night (OR = 2.17, 95% CI 0.95, 4.99). The extreme of long sleep duration (i.e., >10 h per night) increased the risk of myopia (OR = 1.02, 95% CI 1.01, 1.04).
CONCLUSIONS
Inappropriate sleep duration might increase the risk of major eye disorders. The findings could contribute to the growing knowledge on the possible relationship between circadian rhythms and eye disorders.
Topics: Sleep Duration; Humans; Eye Diseases
PubMed: 36683054
DOI: 10.1038/s41433-023-02403-4 -
BMJ Clinical Evidence Aug 2008Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990. Surgery for cataract in people with glaucoma may affect... (Review)
Review
INTRODUCTION
Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990. Surgery for cataract in people with glaucoma may affect glaucoma control.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of surgery for age-related cataract without other ocular comorbidity? What are the effects of treatment for age-related cataract in people with glaucoma? What are the effects of surgical treatments for age-related cataract in people with diabetic retinopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: cataract surgery alone; cataract surgery with non-concomitant glaucoma surgery; concomitant cataract and glaucoma surgery; diabetic retinopathy treatment with cataract surgery; intracapsular extraction; manual (large or small) incision extracapsular extraction; and phaco extracapsular extraction.
Topics: Blindness; Cataract; Cataract Extraction; Evidence-Based Medicine; Glaucoma; Humans; Incidence; Lens, Crystalline
PubMed: 19445812
DOI: No ID Found -
Journal of Ophthalmology 2022We performed a systematic review and meta-analysis to evaluate the association between cataract surgery and the development and progression of AMD. (Review)
Review
PURPOSE
We performed a systematic review and meta-analysis to evaluate the association between cataract surgery and the development and progression of AMD.
METHODS
This meta-analysis was registered at PROSPERO (CRD42017077962). We conducted a systematic literature search in August 2020 in Embase and PubMed and included cohort studies, case-control studies, or randomized controlled trials (RCTs) if they examined the association between cataract surgery and AMD. Odds ratio (OR) was used as a measure of the association with a random effect model. The analysis was further stratified by factors that could affect the outcomes.
RESULTS
15 studies were included in this study. In the overall analysis, cataract surgery was significantly associated with the incidence of late AMD (OR, 1.80; 95% CI, 1.26-2.56; = 0.001), particularly geographic atrophy (OR, 3.20; 95% CI, 1.90-5.39; ≤ 0.001). No significant associations were observed between cataract surgery and the incidence of early AMD. Subgroup analysis showed that the OR for incidence of early and late AMD was significantly higher for cataract surgery performed more than 5 years compared with less than 5 years. We also found an increased risk of progression of AMD after cataract surgery performed more than 5 years (OR, 1.97; 95% CI, 1.29-3.01; = 0.002).
CONCLUSIONS
Our results suggest that cataract surgery may be associated with an increased risk of late AMD development and AMD progression. In addition, increasing the follow-up time since cataract surgery may further increase the risk for the development and progression of AMD. In the future, prospective multicenter studies with well-designed RCTs are required to confirm our findings.
PubMed: 35573811
DOI: 10.1155/2022/6780901 -
BMC Ophthalmology Feb 2018Epidemiological studies suggest that antidepressants use may increase the risk of cataract, but the results are inconclusive. We aimed to examine this association by... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Epidemiological studies suggest that antidepressants use may increase the risk of cataract, but the results are inconclusive. We aimed to examine this association by performing a systematic review and meta-analysis.
METHODS
Relevant studies were identified by searching PubMed and Web of Science databases through June 2017. We included studies that reported risk estimates for the association between antidepressants use and cataract risk. A random-effects model was used to calculate the summary odds ratio (OR) with its 95% confidence interval (CI).
RESULTS
We identified seven studies of antidepressants use and risk of cataract involving 447,672 cases and 1,510,391 controls. Overall, the combined ORs (95% CIs) of cataract for selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenalin reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) were 1.12 (1.06-1.19), 1.13 (1.04-1.24), and 1.19 (1.11-1.28), respectively. A certain degree of heterogeneity was observed across studies (P < 0.001, I = 92.2% for SSRIs, P = 0.026, I = 67.5% for SNRIs, and P = 0.092, I = 58.0% for TCAs).
CONCLUSION
This meta-analysis provides evidence of a significant positive association between antidepressants use and risk of cataract. Because of the heterogeneity and limited eligible studies, further prospective studies are warranted to confirm the preliminary findings of our study.
Topics: Antidepressive Agents; Cataract; Humans; Odds Ratio; Risk Factors
PubMed: 29409486
DOI: 10.1186/s12886-018-0699-0 -
Clinical Ophthalmology (Auckland, N.Z.) 2023Selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS) are increasingly used options for mild-to-moderate open-angle glaucoma (OAG) care.... (Review)
Review
Systematic Literature Review of Clinical, Economic, and Humanistic Outcomes Following Minimally Invasive Glaucoma Surgery or Selective Laser Trabeculoplasty for the Treatment of Open-Angle Glaucoma with or Without Cataract Extraction.
INTRODUCTION
Selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS) are increasingly used options for mild-to-moderate open-angle glaucoma (OAG) care. While most MIGS devices are indicated for use in combination with cataract surgery only, with phacoemulsification playing a role in lowering IOP, newer technologies can also be used as standalone glaucoma surgery.
METHODS
This systematic literature review (SLR) aimed to assess the clinical, economic, and humanistic outcomes of MIGS and SLT for the treatment of OAG and was conducted according to PRISMA guidelines. Studies that assessed MIGS or SLT in at least one treatment arm versus any other glaucoma treatment in adults with mild-to-moderate OAG were included. Clinical, humanistic (health-related quality of life [HRQoL] and patient burden), and economic data were extracted, and the methodological quality of included studies was evaluated.
RESULTS
A total of 2720 articles were screened, and 81 publications were included. Fifty-eight reported clinical outcomes. The majority assessed iStent or iStent inject (n=41), followed by OMNI (n=9), gonioscopy-assisted transluminal trabeculotomy (GATT) or the Kahook Dual Blade (KDB) (n=7), Hydrus (n=6), SLT (n=5), Xen Gel Stent (n=2), PreserFlo (n=1), and iTrack (n=1). IOP reduction was observed across prospective studies, varying from -31% to -13.7% at month 6 and from -39% to -11.4% at year 1 versus baseline. Most adverse events were transient and non-serious. Limited humanistic and economic data were identified.
CONCLUSION
Given their established efficacy and safety, there is a rationale for wider use of MIGS in mild-to-moderate OAG. Of the MIGS devices, iStent and OMNI have the largest clinical evidence base supporting their sustained effectiveness.
PubMed: 36636619
DOI: 10.2147/OPTH.S389406 -
JAMA Ophthalmology Nov 2022A bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice. (Meta-Analysis)
Meta-Analysis
Visual Outcomes and Optical Quality of Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular Lenses in Presbyopia-Correcting Cataract Surgery: A Systematic Review and Bayesian Network Meta-analysis.
IMPORTANCE
A bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice.
OBJECTIVE
To compare outcomes of presbyopia-correcting IOLs frequently recommended in clinical practice through a bayesian NMA based on a systematic review.
DATA SOURCES
Medline (PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on May 15, 2021, from inception.
STUDY SELECTION
Based on the research question, randomized clinical trials assessing multifocal IOLs in patients who underwent bilateral cataract extraction were searched. Nonrandomized studies, studies in patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and nonpeer-reviewed articles were excluded.
DATA EXTRACTION AND SYNTHESIS
Descriptive statistics and outcomes were extracted. The NMA was conducted to compare different types of IOLs. The mean differences for continuous variables, odds ratios for binary variables, 95% credible intervals (CrIs), and ranks of interventions were estimated.
MAIN OUTCOMES AND MEASURES
The outcomes examined included binocular visual acuities by distance and optical quality, including glare, halos, and spectacle independence.
RESULTS
This NMA included 27 studies comprising 2605 patients. For uncorrected near visual acuity, trifocal IOLs (mean difference, -0.32 [95% CrI, -0.46 to -0.19]) and old bifocal diffractive IOLs (mean difference, -0.33 [95% CrI, -0.50 to -0.14]) afforded better visual acuity than monofocal IOLs. Regarding uncorrected intermediate visual acuity, extended depth-of-focus IOLs provided better visual acuity than monofocal IOLs. However, there were no differences between extended depth-of-focus and trifocal diffractive IOLs in pairwise comparisons. For uncorrected distant visual acuity, all multifocal IOLs were comparable with monofocal IOLs. There were no statistical differences between multifocal and monofocal IOLs regarding contrast sensitivity, glare, or halos.
CONCLUSIONS AND RELEVANCE
For patients considering a multifocal IOL due to presbyopia, bilateral implantation of a trifocal IOL might be an optimal option for patients without compromising distant visual acuity.
Topics: Humans; Presbyopia; Network Meta-Analysis; Bayes Theorem; Lenses, Intraocular; Cataract Extraction; Contrast Sensitivity; Cataract
PubMed: 36136323
DOI: 10.1001/jamaophthalmol.2022.3667 -
BMJ Open Aug 2023To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to reduce MVCs.
DESIGN
Medline (Ovid), EMBASE and Global Health electronic databases were systematically searched from inception to March 2022 for observational and interventional English-language studies. Screening, data extraction and appraisals using the Joanna Briggs Institute appraisal tools were completed by two reviewers independently. Where appropriate, measures of association were converted into risk ratios (RRs) or ORs for meta-analysis.
PARTICIPANTS
Drivers of four-wheeled vehicles of all ages with no cognitive declines.
PRIMARY AND SECONDARY OUTCOMES
MVC involvement (primary) and driving cessation (secondary).
RESULTS
101 studies (n=778 052) were included after full-text review. 57 studies only involved older drivers (≥65 years) and 85 were in high-income settings. Heterogeneity in the data meant that most meta-analyses were underpowered as only 25 studies, further split into different groups of eye diseases and measures of vision, could be meta-analysed. The limited evidence from the meta-analyses suggests that visual field defects (four studies; RR 1.51 (95% CI 1.23, 1.85); p<0.001; I=46.79%), and contrast sensitivity (two studies; RR 1.40 (95% CI 1.08, 1.80); p=0.01, I=0.11%) and visual acuity loss (five studies; RR 1.21 (95% CI 1.02, 1.43); p=0.03, I=28.49%) may increase crash risk. The results are more inconclusive for available evidence for associations of glaucoma (five studies, RR 1.27 (95% CI 0.67, 2.42); p=0.47; I=93.48%) and cataract (two studies RR 1.15 (95% CI 0.97, 1.36); p=0.11; I=3.96%) with crashes. Driving cessation may also be linked with glaucoma (two studies; RR 1.62 (95% CI 1.20, 2.19); p<0.001, I=22.45%), age-related macular degeneration (AMD) (three studies; RR 2.21 (95% CI 1.47, 3.31); p<0.001, I=75.11%) and reduced contrast sensitivity (three studies; RR 1.30 (95% CI 1.05, 1.61); p=0.02; I=63.19%). Cataract surgery halved MVC risk (three studies; RR 0.55 (95% CI 0.34, 0.92); p=0.02; I=97.10). Ranibizumab injections (four randomised controlled trials) prolonged driving in persons with AMD.
CONCLUSION
Impaired vision identified through a variety of measures is associated with both increased MVC involvement and cessation. Cataract surgery can reduce MVC risk. Despite literature being highly heterogeneous, this review shows that detection of vision problems and appropriate treatment are critical to road safety.
PROSPERO REGISTRATION NUMBER
CRD42020172153.
Topics: Humans; Visual Acuity; Ranibizumab; Accidents, Traffic; Macular Degeneration; Vision Disorders; Cataract
PubMed: 37567751
DOI: 10.1136/bmjopen-2022-065210